NZ Researchers Help World To Breathe Free Amid Covid-19 Resurgence

Innovative medical technology that could help thousands of Covid-19 patients recover is being offered to hospitals around the world for free by University of Canterbury researchers.

Simple, low-cost technology developed by University of Canterbury (UC) engineers could save thousands of lives by doubling the capacity of ventilators in hospital intensive care units (ICU), boosting the capacity to treat overwhelming patient surges during Covid-19 outbreaks.

In many countries, the Covid-19 pandemic has overwhelmed hospital resources. Worldwide there is a shortage of ventilators because critically ill Covid-19 patients need mechanical ventilation to control breathing and allow recovery, sometimes for more than three weeks.

Distinguished Professor Geoff Chase, of UC’s Mechanical Engineering department and Centre for Bio-Engineering, and UC Engineering PhD student Lui Holder-Pearson, worked with Christchurch Hospital Senior Intensive Care Specialist Dr Geoff Shaw, as well as engineers and senior doctors in Belgium and Malaysia, to create a device that allows two patients to use one ventilator safely and effectively.

“We see the rapid growth and stress on ICU and health resources building throughout Europe, and especially for our Belgian colleagues, and are thus distributing this first, fully tested version open access and freely, as promised, but still in the hope it never has to be used,” Professor Chase says. “The situation in Europe and the United Kingdom is hitting lockdown again, so it’s timely.”

UC researchers made a prototype and validated its safety and efficacy using mechanical lungs attached to two different types of ventilator at UC’s Mechanical Engineering department, with further testing at Christchurch Hospital.

The ‘Active Close-loop Timed-in-series Inspiratory Valve’ or ACTIV system, as UC PhD student Lui Holder-Pearson has named it, is ready for full release and use after these tests.

“We believe this can, and will, save countless lives internationally by doubling ventilator capacity and sparing doctors from having to make terrible end-of-life care choices,” Professor Chase says.

“It will help health systems to weather the Covid-19 pandemic storm when major outbreaks occur by increasing intensive care capacity.

“This is a clever technology. It’s a very simple, quickly implemented, low-cost, but high impact, solution. We developed them locally and have made them available with freely available software and designs to be 3D-printed in hospitals internationally,” Professor Chase says.

This new technology uses mechatronics and modern manufacturing – such as 3D printing – to create an actuated valve and several flow and pressure sensors. These sensors provide feedback as to the state of the ventilator, meaning the valve switches after every breath, diverting every second breath to a second patient. Enabling the single ventilator to ventilate one patient and then another is known as “in series” breathing.

Medical experts have regarded using a single ventilator for more than one patient, where they all breathe together or “in parallel”, as too risky. However, the Canterbury researchers have shown how this low-cost active breathing circuit concept, using “in series” breathing, allows it to be safe. Earlier in the pandemic, their concept was published in leading intensive care medicine journal Critical Care and has been accessed over 1000 times to date.

“This all-new approach will require very little change to current clinical ventilation practice,” Professor Shaw says. “The device and active breathing circuit we’ve proposed is a technology extension that enables each patient connected to a ventilator to be treated individually by the machine, instead of breathing in parallel at the same time, which is higher risk to both patients. We believe our technology could also lead to improvements in other areas of ventilation care.”

The team collaborated with ICU clinicians in Christchurch, Malaysia and Belgium on testing and proof of concept, with the research led from UC, New Zealand. This international team shares over 15 years of joint research on intensive care medicine, creating novel innovations that have significantly improved care and outcomes for many patients.

“This system is another example of how clinicians and engineers can successfully work together to create innovative products that can solve urgent international problems,” Professor Chase says.

Professor Chase is Deputy Director of the New Zealand MedTech Centre of Research Excellence and the MedTech Spearhead leader for the National Science Challenge, Science for Technological Innovation (SfTI), and acknowledges their support. The project to develop, test, and initially deploy the unique system was awarded $150,000 from the Ministry of Business Innovation and Employment’s Covid-19 Innovation Fund.

The UC-led international research team has tested, proven and is now sharing the active breathing circuit system globally on an “open source” basis, so its software and designs are freely available to anyone on the world to use and replicate. The ACTIV system is now freely available to the world’s hospitals and ICUs (Open source via CC-BY-SA licence): https://gitlab.com/luihp/activvent

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